A new study links the increased risk of dementia with certain medications. (Anticholinergic drugs and risk of dementia: case-control study) The focus of the study was on drugs that have anticholinergic effects. Acetylcholine is vital to memory and learning. There are lower levels of this neurotransmitter in the brains of people with Alzheimer’s disease. Additionally, animal studies have shown that anticholinergic drugs may contribute to brain inflammation, another risk factor for dementia.

It’s estimated that approximately 50% of adults in the U.S. take one or more medications with an anticholinergic effect. Some of the most common are:

• amitriptyline (Endep, Elavil), paroxetine (Paxil, Pexeva), and bupropion (Aplenzin, Wellbutin). These drugs are commonly taken for depression)
• oxybutynin and tolterodine, taken for an overactive bladder, found in Ditropan, Oxytrol.
• diphenhydramine, a common antihistamine found in: Advil PM, Aleve PM, Bayer PM, Benadryl, Excedrin PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom, etc.
• Chlorpheniramine, found in Actifed, Allergy & Congestion RElief, Chlor-Trimeton, Codeprex, Efidac-24 Chlorpheniramine, etc.

According to Shelly Gray, professor pharmacy at the University of Washington, and author of  Cumulative Use of Strong Anticholinergics and Incident Dementia” (March 2015, JAMA Internal Med.), the longer people took the drugs and the higher the dose, the higher the risk of dementia, although it’s important to note that short-term use was not linked to higher risks.

Gray suggested that people, especially seniors, who have trouble sleeping find a non-drug therapy for insomnia Celexa and Prozac for depression and Claritin for allergies.  She emphasized that it is important to speak with one’s doctor before stopping a medication that you have been taking.

Natural alternatives

Help for depression

1. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
2. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
3.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
4. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.
5. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
6. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.

Natural sleep aids

1. Try valerian, passion-flower or skullcap herbal tea at least a couple of hours before bedtime.
2. A cup of warm milk with a small pinch of cardamom, coriander, cinnamon, turmeric and cumin, and an 1/8 of a tsp of ghee is a tasty and relaxing bedtime drink. The calcium in the milk is a muscle relaxant and the Indian spices help induce relaxation. Experiment to see which spices you like.
3. Eat a banana. Bananas contain potassium and magnesium that help reduce risk of muscle cramps. These two minerals also support heart health and cognitive function.
4. A drop in blood sugar during the night can cause us to wake up. Although it’s better to not go to sleep on a full stomach, a small protein snack such as a slice of cheese or smear of peanut butter on a cracker can help maintain balanced blood sugar.
5. Melatonin supplements help some people, but you might have to experiment with the dosage. I like Natural Vitality’s Natural Calm, a powdered calcium supplement that you put in water or juice. I also like the homeopathic remedy Hyland’s Calms Forte.
6. Spritz lavender oil on your pillow or put a sachet of lavender flowers under your pillow.

Natural antihistamines

1. Quercetin is a bioflavonoid that is naturally found in plant foods such as apples, cruciferous vegetables (like broccoli or cauliflower), onions/shallots, green tea and citrus fruits. It stabilizes the release of histamines and helps to naturally control allergy symptoms.
2. Apple cider vinegar is my new “go to” remedy for almost everything. I take 1 Tablespoon everyday by pinching my nose and drinking water to flush it down. It helps alkalize the body and supports immune function.
3. Butterbur is a natural herb that is sold as an extract. A study published in August 2005 in Phytotherapy Research found that when compared to an antihistamine, the butterbur extract worked just as well, without the side effect of drowsiness.
4. Remember that Claritin does not contain diphenhydramine, so use it by all means if these other remedies do not do the trick.

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.